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Politics in America

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Expansion of Medicare under Bush:

What is medicare?

Medicare is a social insurance programme for over 65s who have worked and paid into the system and for under 65s who suffer from several disabilities and conditions. It is administered by 30 private companies across the nation and was used by 48 million Americans in 2010, providing them with health assistance when needed.

How did Bush expand it and what was the effect on the federal - state relationship?

George Bush expanded Medicare throughout his terms in office with various increases in spending and acts with his Medicare Prescription Drug, Improvement, and Modernization Act of 2003 being of great significance. It was set to cost $400 billion in its first 10 years, a huge expansion of federal spending and of a federal programme introduced by Democratic president Johnson in 1965 which was seen as a huge increase in the size and role of the federal government compared to the state governments. This can be proven by the opposition faced by Bush by conservatives within his own party in Congress with 25 republicans voting against the act in the House and 9 senators opposing it in the senate, causing Bush to rely on sympathetic democrats to support it. This shows just how far it was from the traditional republican view to federalism and Reagan’s ‘New Federalism’.

Expansion of Medicaid under Obama:

What is medicaid?

starting in the 1980s, Medicaid is similar medicare in the sense that it is a social insurance policy but it is directed at low income families who cannot afford healthcare. Means-testing is used to judge eligibility to the programme and is supported through a mix of federal and state government funding; not all states are forced to support the programme but all do so at the moment.

How did Obama expand it and what was the effect on the federal - state relationship?

Obama’s

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